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How reliable is visual assessment of the electrically elicited stapedius reflex threshold during cochlear implant surgery, compared with tympanometry?

Published online by Cambridge University Press:  05 November 2010

H W Pau ,
K Ehrt ,
T Just ,
U Sievert  and
R Dahl
H W Pau*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
K Ehrt
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
T Just
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
U Sievert
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
R Dahl
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
*
Address for correspondence: Prof Dr Hans Wilhelm Pau, Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Doberaner Str 137–139, 18057 Rostock, Germany Fax: +49 (0)381 494 8302 E-mail: hans-wilhelm.pau@med.uni-rostock.de
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Abstract

Objectives:

To assess the reliability of visually assessed thresholds of the electrically elicited stapedius reflex, recorded during cochlear implant surgery, compared with intra-operative tympanometric threshold assessment. Intra-operatively recorded electrically elicited stapedius reflex thresholds vary considerably, and differ from those measured post-operatively by means of impedance changes (i.e. using tympanometry). Thus, any confounding effect of different intra-operative techniques and visual assessment inaccuracies should be excluded.

Methods:

Both techniques (i.e. visual observation and tympanometry) were performed intra-operatively in six patients, and threshold values were compared.

Results:

Recorded electrically elicited stapedius reflex thresholds were very similar for both techniques. Visually assessed thresholds were slightly higher in some cases and lower in others, compared with tympanometric thresholds.

Discussion:

There was almost no difference between reflex thresholds measured with the two different techniques under the same intra-operative conditions. Therefore, we conclude that differences between intra- and post-operative thresholds are not due to the use of different measuring techniques. The main reason for such differences is probably the influence of intra-operative narcotics on reflex thresholds.

Keywords

Stapedius ReflexThresholdCochlear ImplantChildren

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 3 , March 2011 , pp. 271 - 273
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Stephan, K, Welzl-Müller, K. Post-operative stapedius reflex tests with simultaneous loudness scaling in patients supplied with cochlear implants. Audiology 2000;39:13–18Google Scholar
2Allum, JH, Greisiger, R, Probst, R. Relationship of intraoperative electrically evoked stapedius reflex thresholds to maximum comfortable loudness levels of children with cochlear implants. Int J Audiol 2002;41:93–9CrossRefGoogle ScholarPubMed
3Lorens, A, Walkowiak, A, Piotrowska, A, Skarzynski, H, Anderson, I. ESRT and MCL correlations in experienced paediatric cochlear implant users. Cochlear Implants Int 2004;5:28–37Google Scholar
4Brickley, G, Boyd, P, Wyllie, F, O'Driscoll, M, Webster, D, Nopp, P. Investigations into electrically evoked stapedius reflex measures and subjective loudness percepts in the Med-El Combi 40+ cochlear implant. Cochlear Implants Int 2005;6:31–42CrossRefGoogle ScholarPubMed
5Caner, G, Olgun, L, Gültekin, G, Balaban, M. Optimizing fitting in children using objective measures such as neural response imaging and electrically evoked stapedius reflex threshold. Otol Neurotol 2007;28:637–40Google Scholar
6Wolfe, J, Kasulis, H. Relationships among objective measures and speech perception in adult users of the HiResolution Bionic Ear. Cochlear Implants Int 2008;9:70–81Google Scholar
7Makhdoum, MJ, Snik, AF, Stollman, MH, de Grood, PM, van den Broek, P. The influence of the concentration of volatile anesthetics on the stapedius reflex determined intraoperatively during cochlear implantation in children. Am J Otol 1998;19:598–603Google ScholarPubMed
8Schultz, A, Berger, FA, Weber, BP, Grouven, U, Niclaus, O, Lüllwitz, E et al. Intraoperative electrically elicited stapedius reflex threshold is related to the dosage of hypnotic drugs in general anesthesia. Ann Otol Rhinol Laryngol 2003;112:1050–5Google Scholar
9Crawford, MW, White, MC, Propst, EJ, Zaarour, C, Cushing, S, Pehora, C et al. Dose-dependent suppression of the electrically elicited stapedius reflex by general anesthetics in children undergoing cochlear implant surgery. Anesth Analg 2009;108:1480–7Google Scholar
10Pau, HW, Zehlicke, T, Sievert, U, Schaudel, D, Behrend, D, Dahl, R. Electromyographical recording of the electrically elicited stapedius reflex via a bipolar hook electrode. Otol Neurotol 2009;30:1–6CrossRefGoogle Scholar
11Clement, RS, Kipke, DR. Characteristics of stapedius muscle electromyograms elicited by cochlear implant stimulation in the rat. Conf Proc IEEE Eng Med Biol Soc 2004;6:4221–4Google Scholar
12Almquist, B, Harris, S, Shallop, JK. Objective intraoperative method to record averaged electromyographical stapedius muscle reflexes in cochlear implant patients. Audiology 2000;39:146–52CrossRefGoogle Scholar